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Radiation recall dermatitis with pemetrexed.

J Hureaux1, Y Le Guen, C Tuchais

  • 1Département de Pneumologie, Centre Hospitalier et Universitaire, 4, rue Larrey, 49 933 Angers Cedex 9, France. johureaux@chu-angers.fr

Lung Cancer (Amsterdam, Netherlands)
|August 23, 2005
PubMed
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Pemetrexed chemotherapy can cause radiation recall dermatitis in malignant pleural mesothelioma patients previously treated with radiation. This skin reaction, appearing on irradiated areas, necessitates careful use of pemetrexed post-radiotherapy.

Area of Science:

  • Oncology
  • Dermatology
  • Radiotherapy

Background:

  • Malignant pleural mesothelioma (MPM) treatment often involves chemotherapy and radiation.
  • Pemetrexed in combination with cisplatin is a new first-line chemotherapy for MPM.
  • Limited data exist on the interaction between pemetrexed and prior radiation therapy.

Observation:

  • A case of radiation recall dermatitis is reported in an MPM patient after pemetrexed-cisplatin chemotherapy.
  • The patient had received prior chest wall radiation therapy to thoracoscopy and drainage orifices.
  • Erythematous, pruritic rash developed on irradiated skin 12 days after chemotherapy initiation.

Findings:

  • The skin reaction was graded as 2 according to the Radiation Therapy Oncology Group criteria.

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  • A pemetrexed challenge did not worsen the skin lesions.
  • Skin healing occurred with persistent hyperpigmentation in the irradiated areas.

    • Implications:

    • Pemetrexed may act as a radiosensitizing agent.
    • Caution is advised when using pemetrexed in patients with recent radiation exposure.
    • Further investigation into pemetrexed-radiation interactions is warranted.